What is Infertility?
A Journey of Hope, Healing, and Possibility
What Is Infertility? – Symptoms, Causes, and Treatment
From Uncertainty to Clarity — Navigating Infertility with Knowledge & Care.
Infertility is defined as the inability to get pregnant or carry a pregnancy to term after 12 months of regular, unprotected sex (or six months if the woman is over 35). It affects approximately 1 in 7 couples globally, according to the World Health Organization (WHO), and can involve both male and female factors.
This condition is not just a physical health issue — it deeply affects emotional well-being, relationships, and one’s sense of identity.
Primary vs. Secondary Infertility
Primary infertility
Primary infertility refers to couples who have never been able to conceive or carry a pregnancy to term. This is the most common form of infertility and is often what people think of when they hear the term for the first time. Many couples facing primary infertility discover the issue after months or years of trying to conceive without success, often only seeking help when the emotional toll becomes too heavy.
Secondary infertility
Secondary infertility refers tocouples who have previously conceived and given birth to one or more children but are now struggling to conceive again. Though it may seem less common, secondary infertility can be just as emotionally challenging—sometimes even more so—because it may come with unexpected confusion, grief, or feelings of betrayal by one’s body. These couples may assume that prior success means future conception will come easily, making the disappointment more acute when it does not.
Symptoms of Infertility
Infertility is often identified only after repeated failed attempts to conceive. However, there are certain signs that may suggest underlying fertility challenges. These symptoms can differ between men and women and are sometimes subtle or easily mistaken for unrelated health issues.
In women, the most common symptom is an irregular or absent menstrual cycle, which may indicate that ovulation is not occurring as it should. Some women may also experience unusually painful periods or pain during intercourse, which could point to underlying conditions such as endometriosis. In some cases, women may have regular cycles but still find themselves unable to conceive, highlighting the complexity of female fertility.
In men, infertility symptoms are typically less obvious. The most common indicators include low sperm count, poor sperm motility (movement), or abnormal sperm morphology (shape). Hormonal imbalances can also lead to sexual dysfunction, decreased libido, or changes in body or facial hair, all of which may interfere with fertility. A medical semen analysis is often the first step in identifying male-related fertility issues.
While these symptoms provide important clues, they are not definitive diagnoses. If you suspect you or your partner may be experiencing fertility problems, it is important to seek a thorough medical evaluation.
Causes of Infertility
In women, the most common causes include:
Ovulation Disorders: Hormonal imbalances, such as those caused by polycystic ovary syndrome (PCOS) or thyroid dysfunction, can interfere with the regular release of eggs.
Blocked Fallopian Tubes: Scar tissue from previous infections, surgery, or conditions such as pelvic inflammatory disease can prevent the egg and sperm from meeting.
Endometriosis: This condition occurs when the tissue that normally lines the uterus grows outside of it, potentially affecting the ovaries, fallopian tubes, or uterus itself.
Uterine or Cervical Abnormalities: Fibroids, polyps, or structural issues in the uterus or cervix can hinder implantation or interfere with the sperm’s ability to reach the egg.
Age: A woman’s fertility begins to decline significantly after the age of 35, with a corresponding decrease in egg quality and quantity.
In men, fertility issues are often related to:
Low Sperm Count: A reduced number of sperm can lower the chances of successful fertilisation.
Poor Sperm Motility: If sperm are unable to swim effectively, they may never reach the egg.
Structural Abnormalities: Conditions such as varicocele, a swelling of the veins in the scrotum, can impair sperm production or delivery.
Hormonal Imbalances: Low testosterone or other hormonal issues may affect sperm production and sexual function.
Lifestyle Factors: Smoking, heavy alcohol consumption, obesity, exposure to toxins, and chronic stress can all impair male fertility.
Unexplained Infertility
In some cases, couples undergo comprehensive fertility evaluations and are told that no clear medical reason can be found to explain their difficulties in conceiving. This is known as unexplained infertility, and it accounts for approximately 10 to 20 percent of infertility cases.
While this diagnosis can be particularly frustrating—offering no specific issue to “fix”—it does not mean that conception is impossible. Many couples in this category eventually conceive either naturally or with the assistance of fertility treatments. Treatment plans may include empirical use of medications, intrauterine insemination (IUI), or in vitro fertilisation (IVF), depending on age and other factors.
Treatment Options for Infertility
Infertility treatments are highly individualised and depend on the underlying cause, the age of the partners, and their personal preferences. Treatment should always be guided by a qualified fertility specialist.
Maintaining a healthy lifestyle can improve fertility outcomes. A balanced diet, regular exercise, managing chronic stress, and avoiding harmful substances such as tobacco and excessive alcohol can enhance reproductive health in both men and women.
Fertility medications may be used to regulate or induce ovulation in women. Common options include Clomiphene Citrate and Letrozole. For men, medications may be prescribed to correct hormonal imbalances or support sperm production. In certain cases, surgery may be recommended to address conditions such as endometriosis, fibroids, or varicocele.
Intrauterine Insemination (IUI) involves placing sperm directly into the uterus to increase the likelihood of fertilisation.
In Vitro Fertilisation (IVF) involves retrieving eggs and sperm, fertilising them in a lab, and transferring the resulting embryos into the uterus.
Intracytoplasmic Sperm Injection (ICSI) is a technique used during IVF where a single sperm is directly injected into an egg to assist with fertilisation.
Infertility can place an enormous psychological burden on individuals and couples. Infertility counselling can help clients process their emotions, cope with anxiety and loss, navigate medical decisions, and strengthen their relationships. Counselling can also help couples improve communication and maintain emotional closeness during what is often a difficult and uncertain time.
For those unable or unwilling to pursue further fertility treatments, alternative options exist. Adoption is a legally recognised path to parenthood in Singapore, while surrogacy remains legally restricted within the country. International surrogacy may be considered, but it involves significant legal, financial, and ethical considerations and should be pursued only with professional guidance.
The Emotional Impact of Infertility
The emotional and mental health toll of infertility is often underestimated. The experience may lead to:
Grief and Loss: Feelings of mourning over failed pregnancies or the loss of a hoped-for future.
Stress and Anxiety: Related to the unpredictability of treatments, medical appointments, or financial concerns.
Shame and Guilt: Individuals may internalise blame or feel inadequate, especially in cultures where childbearing is strongly linked to personal or marital identity.
Relationship Strain: Fertility struggles can affect intimacy, communication, and emotional connection between partners.
Seeking support from a qualified counsellor can be vital in helping couples navigate these difficult emotions and find a path forward, whether or not they pursue further treatment.
Practical Coping Strategies
While infertility is a complex and emotionally taxing experience, there are effective ways to cope:
Seek Emotional Support: Talk to a trusted friend, a support group, or a trained counsellor.
Set Realistic Expectations: Understand that treatments may not be immediately successful and prepare emotionally for setbacks.
Prioritise Self-Care: Engage in activities that promote relaxation and joy, such as hobbies, rest, or time with loved ones.
Educate Yourself: Being informed about your medical options can empower decision-making and reduce anxiety.
Consider Professional Help: Counselling can be a valuable resource for processing emotions and strengthening your partnership.
Final Thoughts
Infertility is a deeply personal and often challenging journey that touches every aspect of life—from relationships and self-identity to emotional well-being. With a variety of medical treatments, alternative family-building options, and supportive counselling services, individuals and couples facing infertility can find a path forward that aligns with their values and dreams.
At Listening Ear Counselling & Consultancy, we’re here to support you every step of the way. Our services encompass a holistic approach to infertility, offering specialised support through:
- IVF Counselling: Guiding you through the emotional and relational aspects of in vitro fertilisation and its unique demands.
- Adoption Counselling: Helping you explore adoption as a meaningful path to parenthood, providing emotional support and preparation.
- Sperm and Egg Donation Counselling: Addressing the complexities and emotional considerations involved in third-party reproduction.
- Pregnancy Counselling: Offering support for expectant parents, addressing both the joys and concerns that accompany pregnancy.
- Miscarriage and Pregnancy Loss Counselling: Providing compassionate guidance through grief and helping you navigate the healing process.
Our infertility counselling services are designed to provide you with a safe space to process emotions, build resilience, and make informed, thoughtful family-building decisions. For more information on each of these services, visit our Infertility Counselling page to explore how we can support you on your journey.
Frequently Asked Questions
Infertility is the inability to conceive a child after 12 months of regular, unprotected intercourse (or six months for women over 35). It can be due to various factors affecting one or both partners.
Causes include hormonal imbalances, ovulation disorders, fallopian tube blockages, male sperm issues, and unexplained factors.
Diagnosis involves tests for both partners, including hormone levels, imaging studies, semen analysis, and sometimes genetic testing.
No, surrogacy is not legally permitted in Singapore. However, couples may explore international options with proper legal and counselling support.
Infertility often leads to stress, anxiety, grief, and feelings of inadequacy. Counselling can help manage these emotions and provide support.